Any doctors in the house? Need help..

[SUPERDOC]

Originally Posted by Stonedcl

Doc thinks I have the norovirus says it is going around nj as gwalker mentioned...
Lot of fluids and rest and gave me 30 amoxacillin take 3x a day every 8 hours and finish meds... Still feel very weak and I sweat like a pig last night again is was gross I never sweat zoo much in my sleep as the last 2 days..

Thanks guys..

....He/she thinks that you have Norovirus, which is primary an enteric virus that manifests as Diarhhea/vomitting (neither of which you have complained about), but then gave you an antibiotic - which will do nothing against a virus... what am I missing here?

Of course I was not there to examine you, and as has been said, internet advice is limited at best...

What you have to consider is a differential diagnosis --- every possible cause for your symptoms, and the symptoms you describe are quite non-specific - with a huge differential, then we consider what is most likely - in your case infectious illness - influenza/viral illness being more common..

other factors then play a role - protracted fever, focal symptoms, response to treatment...


Sounds Viral - there may have been something on physical exam that made your physician prescribe an antibiotic, or maybe he/she just thought that that is what you wanted....either way, the expectation is that you will be better in 48-72 hrs... if not, make sure you are re-assessed.

[DARK_KNIGHT]

Originally Posted by SUPERDOC

....He/she thinks that you have Norovirus, which is primary an enteric virus that manifests as Diarhhea/vomitting (neither of which you have complained about), but then gave you an antibiotic - which will do nothing against a virus... what am I missing here?

Of course I was not there to examine you, and as has been said, internet advice is limited at best...

What you have to consider is a differential diagnosis --- every possible cause for your symptoms, and the symptoms you describe are quite non-specific - with a huge differential, then we consider what is most likely - in your case infectious illness - influenza/viral illness being more common..

other factors then play a role - protracted fever, focal symptoms, response to treatment...


Sounds Viral - there may have been something on physical exam that made your physician prescribe an antibiotic, or maybe he/she just thought that that is what you wanted....either way, the expectation is that you will be better in 48-72 hrs... if not, make sure you are re-assessed.

..... double post........sorry.

[DARK_KNIGHT]

Originally Posted by SUPERDOC

....He/she thinks that you have Norovirus, which is primary an enteric virus that manifests as Diarhhea/vomitting (neither of which you have complained about), but then gave you an antibiotic - which will do nothing against a virus... what am I missing here?

Of course I was not there to examine you, and as has been said, internet advice is limited at best...

What you have to consider is a differential diagnosis --- every possible cause for your symptoms, and the symptoms you describe are quite non-specific - with a huge differential, then we consider what is most likely - in your case infectious illness - influenza/viral illness being more common..

other factors then play a role - protracted fever, focal symptoms, response to treatment...


Sounds Viral - there may have been something on physical exam that made your physician prescribe an antibiotic, or maybe he/she just thought that that is what you wanted....either way, the expectation is that you will be better in 48-72 hrs... if not, make sure you are re-assessed.

Purulent discharge from the palatine tonsils , perhaps??

Yes ! Go back as many times as needed.

[keschete]

Originally Posted by SUPERDOC

....He/she thinks that you have Norovirus, which is primary an enteric virus that manifests as Diarhhea/vomitting (neither of which you have complained about), but then gave you an antibiotic - which will do nothing against a virus... what am I missing here?

Of course I was not there to examine you, and as has been said, internet advice is limited at best...

What you have to consider is a differential diagnosis --- every possible cause for your symptoms, and the symptoms you describe are quite non-specific - with a huge differential, then we consider what is most likely - in your case infectious illness - influenza/viral illness being more common..

other factors then play a role - protracted fever, focal symptoms, response to treatment...


Sounds Viral - there may have been something on physical exam that made your physician prescribe an antibiotic, or maybe he/she just thought that that is what you wanted....either way, the expectation is that you will be better in 48-72 hrs... if not, make sure you are re-assessed.

You as well as I know how all that works. I try to give the viral spiel and send people home with prescriptions for symptomatic meds......within 24 hours or less the person calls back because they aren't better.

I hate to say it, but in the US healthcare is consumer driven. Sometimes people get prescriptions they don't need because if you don't diagnose them with what they read that they have on the internet....well frankly you are the idiot. I wish it was different, but that is how it works because we are a capitalistic society and people can go where they want for healthcare.

So basically, if you don't do what is expected, you don't get return clientelle. I try very hard to be honest and treat patients as they deserve to be treated. Some days, it gets really difficult and it is easy to just give the customer what they want.

It has been a LONG winter season

I am VERY ready for the summer tonsillectomy season....(just the kid part not the adults) hehehehehe!

[joeychitwood]

As an ER doc, I was constantly frustrated by people who came to see me, were diagnosed with a viral infection and sent home with supportive measures, and then filed a complaint later because I didn't give them an antibiotic like the clinic doc did when they went in the following day. Because were were always swamped, I didn't feel any pressure to give the patient what he/she wanted rather than needed just to keep them as a return customer. Society will pay the price in the future as antibiotics lose their effectiveness due to improper use, and it's the fault of health care providers who cave in to patient expectations rather than stand up for the appropriate treatment.

[DARK_KNIGHT]

We're already at or past the point of abuse of AB's and to make matters worse the pharmaceuticals are not investing in newer generations (without some form of subsidizing). It's precisely the attitude of: "liability"......... "a friend of mine takes this"..........."someone I know recommended that"..............."I feel better, so I'll stop taking the treatment".........that has us at this stage.

[keschete]

I totally agree, but what do you do in a private clinic? I used to work in the ER and frankly did what was waranted, not what was demanded.

It gets hard in private practice. I tend to use a lot of older antibiotics and reserve the newer, multispectrum drugs for serious bacterial infections.

I also order lab work on a lot of kids with prolonged fever and I catch a lot of Mono with EBV titers. I can make a real case with the lab work for not giving abx.

I wish there was a better system of educating patients. It seems like modern times, brings patients who are plugged in to social media and more trusting of their FB friends than the real educated providers.

I wish there was some type of answer. I try to do a lot of education especially in pediatric patients and sometimes give a script and ask the parents to wait 2 or 3 days before filling it. I wish there was some way to know if they actually wait.

[Stonedcl]

Originally Posted by SUPERDOC

....He/she thinks that you have Norovirus, which is primary an enteric virus that manifests as Diarhhea/vomitting (neither of which you have complained about), but then gave you an antibiotic - which will do nothing against a virus... what am I missing here?

Of course I was not there to examine you, and as has been said, internet advice is limited at best...

What you have to consider is a differential diagnosis --- every possible cause for your symptoms, and the symptoms you describe are quite non-specific - with a huge differential, then we consider what is most likely - in your case infectious illness - influenza/viral illness being more common..

other factors then play a role - protracted fever, focal symptoms, response to treatment...


Sounds Viral - there may have been something on physical exam that made your physician prescribe an antibiotic, or maybe he/she just thought that that is what you wanted....either way, the expectation is that you will be better in 48-72 hrs... if not, make sure you are re-assessed.

I think you are correct.. The doctor is a idiot, I did not go to my primary physician because they where booked until Friday (which is today ) but i went on wensday. I have no clue why he gave me this stuff, it just gave me diarrhea. I am feeling better even though I still have the sweats, headache and a fever.. I went to the IMCC because they had walk ins and the doc seemed uninterested just wanted to give me "something" and get me out of there.. He kept asking me if my sinus hurt and kept trying to blame my sinuses asking if i ever had a sinus infection or something else sinitious or something like that... I am slowly getting better and getting my appetite and energy back but i do not think it is from the ammoxicillin he gave me. He told me every 8 hours and finish it 30 of them but I do not think it helped one bit..
Should I finish it even if I fully recover by say Sunday?
Thanks for the help guys!!
And I think the american health care system is screwed up.. In the 3 hours I sat there sick as a dog waiting there where 3 different groups of well dressed salesman selling him there wares and trying to get him to precscribe everyone there drugs.. I guess he got a kick back from the company that makes ammoxicillin and thats why he gave it to me!!